Relationship between Stage of Change for Three Health Behaviors and Perceived Stress in Chinese Adults

Background: Cardiovascular disease is the leading cause of death in China. Objectives: We aimed to evaluate the levels of cardiovascular health among Chinese adults and to understand the geographic patterns based on a nationally and provincially representative survey. Methods: In 2015, a total of 74,771 respondents aged ≥ 20 years with no history of cardiovascular disease were randomly sampled from 298 counties/districts of 31 provinces in mainland China and were interviewed. Seven metrics, including smoking, body mass index, physical activity, diet, total cholesterol, blood pressure, and fasting glucose, were determined. Ideal cardiovascular health was defined as the simultaneous presence of all metrics at the ideal level. A score ranging from 0 to 14 was calculated as the sum of all seven metrics for each province. Scores for four health behaviors and four health factors were also calculated. Results: The age-adjusted prevalence of ideal cardiovascular health was only 1.13% among Chinese adults above 20 years old in 2015 (0.50% among men and 1.77% among women; 1.63% among urban residents and 0.68% among rural residents). The age-adjusted prevalence varied greatly across provinces, ranging from 0.05% in Qinghai to 2.97% in Heilongjiang. Ideal diet (7.4%) was the least common among seven cardiovascular health metrics and ideal blood pressure (32.2%) was the second least one. We also saw significant heterogeneity among provinces in age-adjusted cardiovascular health score, health behavior score, and health factors score. In all provinces, women had higher scores than men for cardiovascular health, health behaviors and health factors. Differences in cardiovascular health and health behavior scores between urban and rural areas were associated with levels of socio-economic development. Conclusions: Strategies for addressing poor cardiovascular health require geographic targeting and localized consideration.

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Feasibility of Using a Mobile App for Stress in Middle-Aged Men and Women. (Preprint)

10.2196/preprints.30294 ◽

2021 ◽

Author(s):

Breanne Michelle Laird ◽

Megan Puzia ◽

Linda Larkey ◽

Diane Ehlers ◽

Jennifer Huberty

Keyword(s):

Physical Activity ◽

Health Behaviors ◽

Perceived Stress ◽

Mindfulness Meditation ◽

Eating Habits ◽

Psychological Outcomes ◽

Middle Aged ◽

Men And Women ◽

General Coping ◽

Middle Aged Adults

BACKGROUND Middle-aged adults (40 to 65 years) report higher stress than most age groups. There is a need to test the feasibility of using a meditation app to reduce stress and improve stress-related outcomes in both middle-aged men and women. OBJECTIVE Therefore, the purpose of this study was to: (1) determine the feasibility (i.e., acceptability and demand) of a consumer-based meditation app (i.e., Calm) to reduce stress in middle-aged adults reporting elevated stress; and (2) explore the preliminary effects of Calm on perceived stress, psychological outcomes (i.e., anxiety, depressive symptoms, mindfulness, general coping), health behaviors (i.e., physical activity, eating habits), and perceptions of COVID-19. METHODS The current study is a double-blind randomized controlled feasibility study testing a brief app-based meditation (i.e., Calm) intervention in middle-aged adults (N=83) with elevated stress levels (i.e., score greater than or equal to 15 on the Perceived Stress Scale) and limited or no previous experience with meditation. Participants were randomized to an app-based meditation intervention (Calm) or app-based education control group (POD). Participants completed self-report assessments at baseline and post-intervention (Week 4). Feasibility was measured as acceptability and demand using Bowen’s framework. Feasibility and COVID-19 perceptions data were examined via descriptive statistics. Preliminary effects were examined using repeated-measures analysis of variance. RESULTS Participants were satisfied with the meditation intervention (96.4%; 27/28) and found it appropriate/useful (92.9%; 26/28). Most reported that they were likely to continue using Calm in the future (64.3%; 18/28). More participants in the Calm group reported satisfaction, appropriateness/usefulness, and intent to continue use compared to the control. Calm participants (n=33) averaged 20.0±31.1 minutes of meditation on the days they meditated and 103±109.1 minutes of meditation per week during the study. On average there was a 70.8% adherence rate to the prescribed meditation, compared to 62.2% in POD. Recruitment of men into the study was 34.9% (29/83). Of those randomized to Calm, 55.2% (15/29) were men. Retention among men was 93.3% (14/15) compared to 60% (12/20) for women. No significant within or between group differences in stress or psychological outcomes related to stress were observed nor were significant differences in health behaviors related to stress. CONCLUSIONS A four-week, app-based mindfulness meditation intervention (i.e., Calm) may be feasible in middle-aged adults. Calm participants expressed satisfaction with the intervention and felt it was appropriate and useful. However, significant improvements in perceived stress and psychological outcomes (i.e., anxiety, depressive symptoms, mindfulness and general coping) or health behaviors related to stress (i.e., physical activity, eating habits) were not observed. The majority of participants reported that COVID-19 negatively impacted their stress, mental health, and physical health. More research is needed for improving stress and stress related outcomes in middle-aged men and women using mindfulness meditation apps. CLINICALTRIAL ClinicalTrials.gov NCT04272138; http://clinicaltrials.gov/ct2/show/NCT04272138.

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PERCEIVED STRESS, SOCIAL SUPPORT, AND DRY MOUTH AMONG U.S. OLDER CHINESE ADULTS

Innovation in Aging ◽

10.1093/geroni/igz038.119 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S31-S31

Author(s):

Weiyu Mao ◽

Yiwei Chen ◽

Bei Wu ◽

Shaoqing Ge ◽

...

Keyword(s):

Social Support ◽

Oral Health ◽

Perceived Stress ◽

Dry Mouth ◽

Chinese Adults ◽

Friend Support ◽

Older Chinese ◽

Older Chinese Adults ◽

The Relationship

Abstract Dry mouth is a common condition among older adults that negatively influences oral health, general health, and quality of life. The role of psychosocial factors in oral health conditions and diseases remains largely unknown. We examined the relationship between perceived stress and dry mouth among US older Chinese adults and further investigated the moderating role of social support from different sources in the relationship. Data came from baseline of the Population Study of Chinese Elderly in Chicago between 2011 and 2013 (N = 3,157). Stepwise logistic regression models with interaction terms were used. More perceived stress was significantly associated with a higher likelihood of reporting dry mouth. Friend support was protective against dry mouth. The effect of perceived stress on dry mouth varied by levels of family and friend support. To prevent or reduce dry mouth, interventions need to consider perceived stress and social support in this growing population.

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Single-Item vs Multiple-Item Measures of Stage of Change in Compliance with Prescribed Medications

Psychological Reports ◽

10.2466/pr0.94.1.115-124 ◽

2004 ◽

Vol 94 (1) ◽

pp. 115-124 ◽

Cited By ~ 10

Author(s):

Christopher L. Cook ◽

Matthew Perri

Keyword(s):

Health Behaviors ◽

Stages Of Change ◽

Transtheoretical Model ◽

Behavioral Change ◽

Stage Of Change ◽

Multiple Choice ◽

Single Item ◽

Multiple Item ◽

Change Measure

The Stage of Change construct from the Transtheoretical Model of behavioral change has been widely utilized in the assessment of various health behaviors. The majority of these tests measure the Stage of Change construct using the single-item, multiple-choice format. This study validated the use of a single-item measure in measuring readiness to comply with taking a prescribed medication. A sample of 161 subjects tested the multiple-item Stage of Change measure, then a refined multiple-item survey was tested with 59 subjects. With the latter survey, discriminating subjects at the differing stages of change dimensions was difficult. A correlation of .91 was found for stage classifications between ratings on the single-item and multiple-item scales. The use of the single-item measure seems reasonable when assessing stage of change in compliance with prescribed medication.

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The Effects of Perceived Stress on Reactions to Messages Designed to Increase Health Behaviors

Journal of Behavioral Medicine ◽

10.1007/s10865-005-9009-4 ◽

2005 ◽

Vol 28 (5) ◽

pp. 425-432 ◽

Cited By ~ 5

Author(s):

Murray Millar

Keyword(s):

Health Behaviors ◽

Perceived Stress

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The Impact of Health Behaviors on Health-Related Quality of Life in College Students

Current Developments in Nutrition ◽

10.1093/cdn/nzab038_051 ◽

2021 ◽

Vol 5 (Supplement_2) ◽

pp. 439-439

Author(s):

Kayla Parsons ◽

Leigh Neptune ◽

Ashley Reynolds ◽

Amelia Sullivan ◽

Carol Byrd-Bredbenner ◽

...

Keyword(s):

Quality Of Life ◽

Mental Health ◽

College Students ◽

Health Behaviors ◽

Perceived Stress ◽

Poor Mental Health ◽

Health Related Quality ◽

Related Quality ◽

Health Related

Abstract Objectives The objective was to explore the influence of health behaviors on health-related quality of life (HRQOL) among college undergraduate students. Methods A convenience sample of college students completed an online survey consisting of the Center for Disease Control's HRQOL modules, perceived stress scale, sleep questionnaire, and the National Cancer Institute Fruit and Vegetable (FV) Screener. Body mass index (BMI) was calculated using self-reported height and weight. Independent t-test were used to compare HRQOL between students who consumed above/below average fruit and vegetable intake. Two multiple regression analyses were used to determine health factors that predicted better HRQOL. Results Participants (N = 655) were 19.8 ± 1.5 years old, female (63%), and white (84%). The average FV intake was 2.2 servings per day. Students who consumed more than the average intake of FV, reported more days/month (d/m) feeling healthy and full of energy (11.9 ± 8.6 vs. 8.9 ± 7.9, P < 0.001), and reported less d/m of poor mental health (8.5 ± 8.1 vs. 11.1 ± 9.8, P < 0.001) compared to those who consumed less than the average. Two predictors explained 38.5% of variance in d/m when mental health was not good (r2 = 0.38, F (2,639) = 200.11, P < 0.001): perceived stress (β = 0.61, P < 0.001) and FV intake (β = −0.08, P < 0.05). Four predictors explained 30.0% of the variance in d/m feeling happy and full of energy (r2 = 0.29, F (4,549) = 58.6, P < 0.001): perceived stress (β = −0.46, P < 0.001), BMI (β = −0.11, P < 0.01), FV intake (β = 0.16, P < 0.001), and hours of sleep (β = 0.08, P < 0.05). Conclusions This data shows that students who consumed above average FV intake reported more days of feeling happy and full of energy and less days of poor mental health, and that modifiable behaviors (FV intake, stress, sleep) impact HRQOL of young adults. This research provides justification for college aimed wellness interventions to include both nutrition education and mental health resources to improve overall HRQOL. Funding Sources This project was supported by the USDA National Institute of Food and Agriculture, Hatch project number #ME0022104 through the Maine Agricultural & Forest Experiment Station. NJ Agriculture Experiment Station.

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IS EXERCISE STAGE OF CHANGE RELATED TO OTHER HEALTH BEHAVIORS?

Medicine & Science in Sports & Exercise ◽

10.1097/00005768-199905001-01333 ◽

1999 ◽

Vol 31 (Supplement) ◽

pp. S273

Author(s):

J. A. Sarkin ◽

C. R. Nigg ◽

G. J. Norman ◽

J. S. Rossi

Keyword(s):

Health Behaviors ◽

Stage Of Change

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Psychological Factors of Long-Term Dietary and Physical Activity Adherence among Chinese Adults with Overweight and Obesity in a Community-Based Lifestyle Modification Program: A Mixed-Method Study

Nutrients ◽

10.3390/nu12051379 ◽

2020 ◽

Vol 12 (5) ◽

pp. 1379 ◽

Cited By ~ 1

Author(s):

Alice W. Y. Leung ◽

Ruth S. M. Chan ◽

Mandy M. M. Sea ◽

Jean Woo

Keyword(s):

Mixed Method ◽

Self Efficacy ◽

Lifestyle Modification ◽

Stage Of Change ◽

Overweight And Obesity ◽

Mixed Method Study ◽

Chinese Adults ◽

Community Based ◽

Lifestyle Modification Program

There is a paucity of research on factors influencing long-term adherence to lifestyle modification. We conducted a mixed-method study to explore the psychological factors of dietary and physical activity (PA) adherence among Chinese adults with overweight and obesity at 10 months after enrollment of a community-based lifestyle modification program in Hong Kong. We recruited Chinese adults newly enrolled in a culturally adapted lifestyle modification program and followed them for 10 months. For the quantitative study, primary outcomes were dietary and PA adherence scores while secondary outcomes included knowledge, self-efficacy, motivation and stage of change. For the qualitative study, data were collected using semi-structured interviews and observation. A total of 140 participants completed the 10-month follow-up. They reported moderate level of dietary adherence but low level of PA adherence at 10 months. Multivariable regression analyses revealed that greater improvement in nutrition knowledge and diet stage of change predicted higher dietary adherence while greater improvement in PA self-efficacy and PA stage of change predicted higher PA adherence. Qualitative data on 26 participants suggest that participants’ knowledge and self-efficacy but not motivation were enhanced during the program. The findings of this study enhanced our understanding on factors influencing long-term adherence to lifestyle changes.

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